November 2011 - Cancer-related hair loss

Cancer Hair Loss

One of the most distressing side effects of cancer treatment is hair loss (alopecia). The threat of hair loss can intensify the loss of control people often feel after a cancer diagnosis. For those who experience it, hair loss can be devastating in many ways.

Losing your hair can make you feel vulnerable and exposed as a “cancer patient.” You may feel self-conscious or embarrassed. And, you may be faced with questions from others that you aren’t prepared to deal with yet. Hair loss is also a tangible sign that your life has changed, which can trigger feelings of anger and depression.

These, and all the other challenges of cancer, can take a toll on your self-image and overall well-being. It helps to understand why hair loss happens, and how to handle it if it occurs.

What Causes Hair Loss?

Cancer treatment targets rapidly-dividing cancer cells. Yet, some healthy cells in the body also divide rapidly, like those lining the mouth and stomach, and in the hair follicles. When cancer treatments, like certain chemotherapies, damage the healthy, fast-growing cells responsible for hair growth, hair loss may result.

Some chemotherapy drugs that typically cause hair loss include: Adriamycin®, Taxol® and Cytoxan®. Radiation therapies can cause hair loss in the particular area of the body being treated.

When/How Does Hair Loss Occur?

Although hair loss does not always happen right away, it usually begins within two weeks of starting chemotherapy and gets worse within 1-2 months. Hair loss in the area being treated with radiation usually begins 2-3 weeks after the first treatment. Hair loss may continue throughout treatment and up to a few weeks afterward.

Hair loss can occur on the head and/or elsewhere on the body, including the face (eyelashes and eyebrows), arms, legs, underarms and pubic area.

Who Experiences Hair Loss?

Not every person will lose their hair during cancer treatment. Even two individuals taking the same medication can have different responses. If it does occur, the extent of hair loss varies widely depending on the type, dosage, frequency and method of treatment, as well as other individual factors.

In some situations, the hair may simply become thin, dull and dry. When hair loss occurs, hair may fall out gradually, quickly, in clumps, or entirely. Sometimes, the scalp feels tender or itchy beforehand.

Will Hair Grow Back?

Most hair loss is temporary and hair will grow back after cancer treatment is complete. Hair generally grows back 1-3 months after chemotherapy ends and 3-6 months after radiation ends. Sometimes hair re-growth begins even before therapy is complete. It’s common for hair to grow back a slightly different color and texture (e.g., curlier) at first.

Dealing With Hair Loss

When you're struggling with cancer and all the challenges that come with it, it can be difficult to adjust to changes like hair loss. Although strategies to prevent hair loss during cancer treatment are being investigated, none have proven effective. Fortunately, hair usually grows back after treatment.

Nevertheless, there are ways to prepare for and deal with hair loss when it occurs. It takes acceptance, understanding, and support from others, but you can learn how to adjust to these changes and focus on healing.

12 Tips for Coping With Cancer-Related Hair Loss

Give yourself time. Losing your hair can be difficult to accept. It may take time to adjust to how you look, and then some more time to feel good about yourself again. It’s okay to feel upset and grieve your losses. At the same time, understand that losing your hair is usually temporary and hair will re-grow after you complete treatment.

Remember you’re still you. Hair loss on any part of the body can come as a shock. It can be disorienting to look in the mirror and not recognize yourself. You may feel like you’re losing part of your identity. Remember that you’re still the same person on the inside. Try to celebrate who you are and focus on those qualities.

Prepare ahead for hair changes. Before you begin cancer treatment, prepare in advance for changes to your hair. Talk to your doctor about what to expect. Meet with a stylist who is familiar with cancer-related hair loss. Some people choose to wear head coverings, and others don’t. Choose whatever feels most comfortable for you. It also helps to think about how you will respond to reactions from others.

Consider head coverings. If you decide to get a wig, hairpiece or other head coverings (e.g., turbans, caps, scarves, hats, head wraps), do so before hair loss occurs. The American Cancer Society Look Good, Feel Better Beauty Guide provides suggestions for flattering ways to tie scarves, etc. If you get a wig, find a specialty shop that matches your natural hair color and texture and get it styled ahead of time. Some insurance plans or assistance programs may help to cover the expense.

Cut your hair short before treatment. Before cancer treatment begins, consider getting a stylish short cut, especially if you have long hair. When hair begins to fall out, it may not be as startling or distressing if your hair is already short. Cutting your hair can also help you feel like you’re taking control. Some people shave their heads once hair begins to fall out to prevent scalp irritation or itchiness.

Be gentle on your hair. Use a soft bristle hair brush or wide-tooth comb and a mild, gentle shampoo (but limit washing). Take special care of the scalp, which may get dry and itchy. Gently pat hair dry with a soft towel. Limit the use of hair clips, barrettes, elastic bands, and pins that pull on hair. As new hair grows in, it may be brittle and delicate and will need special care as well.

Protect your head. Wear a hair net at night, or sleep on a satin pillowcase, to keep hair from coming out in clumps. When out in the sun, use sunscreen to protect your scalp, as sunburn can cause more itchiness, flakiness, and dry skin. In cold weather, wear a hat or scarf outdoors to protect your head.

Emphasize your assets. Experiment with ways to enhance your appearance so you can feel good about yourself. Get new makeup and clothes to accentuate your other features. Take care of your skin and nails. If eyebrows and eyelashes start to fall out, choose eyebrow pencils and eyeliners that are the same color as your natural color or a shade lighter. Keep up with routine hygiene activities.

Pamper yourself. It’s normal to have feelings of anger, frustration or anxiety about hair loss. Take time to do something pleasurable to take your mind off it. Watch a movie, read, take a walk, listen to music, get a manicure, pedicure, facial or massage. Try mind-body therapies, such as relaxation techniques, deep breathing and meditation.

Maintain a healthy lifestyle. A healthy diet, staying hydrated and regular exercise are important for looking and feeling better about yourself. Talk with your doctor about making healthy lifestyle choices. A dietitian can help develop a nutritious meal plan, and a rehabilitation therapist can help develop a personalized exercise plan for you.

Build a support system. Share the challenges of hair loss with friends and family. Also, a cancer support group is a great way to meet other people dealing with hair loss. In this setting, you can get ideas and advice about how others coped with changes in their appearance. You may also find it helpful to meet with a psychologist or counselor.

NOTE: THIS INFORMATION IS NOT INTENDED NOR IMPLIED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTHCARE PROVIDER REGARDING HAIR LOSS DURING CANCER CARE.